Disclosure Statement
Gabriela A. Pirralho, MSW, LICSWA, SUDPT
Gabi the Shrink PLLC
Please take the time to carefully read this disclosure statement. As my client, you have the right to know my qualifications, methods, and mutual expectations of our professional relationship. The information presented here is provided to help you decide if my services are suitable for your needs. Please discuss any questions or concerns you may have either now or during the course of your treatment.
My qualification and license
I am a licensed independent clinical social worker associate in Washington State (license# SC 60769692). I received my Master’s Degree in 2017 from the University of Washington. My professional background involves working both at DESC and Harborview Mental Health and Addictions Clinic, with internships at Swedish and the Municipal Court of Seattle. My experience as a mental health practitioner equipped me to work with individuals, couples and families with a wide range of issues including depression, anxiety, acute mental health diagnoses, addiction, codependency, trauma and relationship issues.
The Therapeutic Process
I believe that therapy is about finding your authentic self and learning to embrace suffering that is part of life. A counseling relationship between a Licensed Counselor and the client is a professional relationship in which the counselor assists the client in exploring and resolving difficult life issues. I believe that when individuals become more accepting of themselves, and more aware of their thoughts, emotions and actions, they are more capable of making decisions which lead to happiness and fulfillment in their lives. Self-awareness and self-acceptance are goals that sometimes take a long time to achieve. While some clients may need only a few counseling sessions to achieve their personal goals, others may require months or even years of counseling. My therapeutic modality is a blend of psychodynamic, mindfulness and behavioral therapies. Therapy has both benefits and risks. During the course of therapy, you might notice changes in your symptoms, problems, and functioning. Since we will be exploring challenging territory in your life, you might experience greater difficulty throughout our work. Therapy typically produces benefits over time, but sometimes as you get to the root of tender issues, you may feel them even more acutely than in the past. I cannot offer any promise or guarantee about the results you will experience. However, as you commit yourself to work through your vulnerable issues and build upon your strengths, it is likely that you will see improvements throughout our work and in the future. I vow to collaborate with you, and to be by your side on this path to personal growth and balance. You have the right - and I will encourage you - to participate in your ongoing treatment plans. You also have the right to refuse any recommended services or modality, though I again encourage you to discuss this with me. I see our relationship as collaborative and personally empowering for you, rather than hierarchical.
I usually work with all my clients on a weekly basis. If you cancel several sessions, which I perceive as a barrier to a positive therapeutic process, I will ask that you be removed from your recurring appointment slot and be placed on my on-call list. The on-call list creates sessions based on cancellations. I will reach out to you by phone as those times become available. If you do not show up to your appointment without notifying me, all your future appointments will be canceled until I hear from you.
Client’s Rights and Responsibilities
Clients have the right to choose a therapist who best suits their needs and purposes. You may ask questions about treatment at any time and may choose to terminate therapy at any time. Therapy may also be ended when I feel that your needs will be better met by another provider. In that case, I will try my best to make appropriate referrals. If you have any concerns or complaints, you may contact the Department of Health. Health Systems Quality Assurance Complaint Intake 360-236-4700 HSQAComplaintIntake@doh.wa.gov P.O. Box 47857 Olympia, WA 98504-7857
Services
I offer therapy service for individuals, couples and families. I see clients 18 years old and above. I do NOT offer case management services, which include but are not limited to providing paperwork for disability, unemployment, custody, adoption, foster care, car accidents and any type of legal issues. I do not offer therapy for individuals who are court mandated for treatment or seeking treatment in which disclosure of sessions will need to be provided to an outside entity. Our work together is limited to the scheduled sessions we have together which are limited to 55 minutes in length. If you would like to continue the session beyond this time, and I don’t have another client scheduled, you will be expected to pay my fee prorated for the extended time. It is important that you realize that although our sessions may be very intimate, we have a professional, rather than a personal, relationship. Our contact will be limited to only the paid sessions we have together; please do not invite me to social engagements, offer gifts, or expect me to relate to you in any way outside our therapy sessions. You will be served best if our relationship stays strictly professional and if our sessions concentrate exclusively on your concerns.
Financial Responsibilities
Please confirm your insurance coverage and patient responsibility before your first appointment with me. Your co-pay or patient responsibility (deductible) determined by your insurer is due at each visit before your session begins. My private pay rate is $90.00 per 55-minute session for individuals and $115.00 per 55-minute session for couples/families. If you are unable to pay the associated fees at the time of service for more than one visit, without developing a payment plan, your future appointments will be suspended until unpaid balances are resolved. Additional fees may apply to preparation of requested documents or copying and sending records. I will discuss any fees with you at the time of a request. Your appointment time is reserved specifically for you, and I will ask all my clients to respect this time. A minimum of 24 hours’ notice is required to reschedule or cancel without a fee. A $75.00 fee is assessed for cancellations on a shorter notice than 24 hours’ and no-shows, at my discretion. Insurance cannot be billed for missed sessions. Since this fee is assessed at my discretion, please direct all questions to me, not the administrative staff.
Confidentiality and Access to Records
With few exceptions, our meetings will remain completely confidential. Without your written consent, everything that is said during sessions is held in strictest confidentiality. There are exceptions to this confidentiality, however; these include:
Any information or suspicion of child or elder abuse, neglect, sexual abuse or incest.
Serious threat of danger to yourself, as in potential suicide.
Serious threat of danger to another, or contemplation of a serious crime.
Court-ordered request for your records.
Requests by 3rd-party billings (insurance companies) to provide diagnosis, records, or statement of service.
I keep brief notes of your sessions. You have the right to a copy of your medical records at any time. A response to your request will be made within 15 working days; this is in compliance with RCW 70.02.080.